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Individual

JOHN WAYNE VAN NATTA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1100 SHARON PARK DR APT 20, MENLO PARK, CA 94025-7083
(650) 926-9660
Mailing address
1100 SHARON PARK DR APT 20, MENLO PARK, CA 94025-7083
(650) 926-9660

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
G21505
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00G215050
CA
Enumeration date
10/03/2006
Last updated
04/08/2009
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